AIM: To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS: Patients between 18 and 80 years old, with chronic complaints (blood loss, pain, itching or prola...AIM: To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS: Patients between 18 and 80 years old, with chronic complaints (blood loss, pain, itching or prolapse) of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope (preloaded with 7 bands). Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS: Forty-one patients were included (median age 52.0, range 27-79 years, 20 men). Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group (P 〈 0.05). Pain after ligation tended to be more frequent in patients treated with the flexible endoscope (first treatment: 3 vs 20 patients, P 〈 0.05). Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION: Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.展开更多
AIM:To evaluate the diagnostic efficacies of narrowband imaging(NBI) endoscopy with and without high magnification in distinguishing neoplasia from nonneoplasia colorectal lesions.METHODS:A total of 118 patients with ...AIM:To evaluate the diagnostic efficacies of narrowband imaging(NBI) endoscopy with and without high magnification in distinguishing neoplasia from nonneoplasia colorectal lesions.METHODS:A total of 118 patients with 123 colorectal lesions examined by NBI endoscopy in the Zhejiang Provincial People's Hospital from September 2008 to April 2010 were enrolled in this study.These lesions were classified by pit pattern and capillary pattern,and then assessed by histopathology.RESULTS:Ten lesions not meeting the diagnostic criteria were excuded,the overall diagnostic accuracy of NBI endoscopy in distinguishing neoplasia from non-neoplasia colorectal lesions was 91.2%(103/113),and that of NBI endoscopy with and without high magnification was 93.0%(40/43) and 90.0%(63/70),respectively.Both were significantly higher than that of conventional colonoscopy reported in the literature(P < 0.05),but there was no significant difference between the two groups(P > 0.05).CONCLUSION:Besides NBI magnifying endoscopy,NBI endoscopy without magnification may also be used to distinguish neoplasia from non-neoplasia colorectal lesions.展开更多
AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of...AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. RESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.展开更多
文摘AIM: To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS: Patients between 18 and 80 years old, with chronic complaints (blood loss, pain, itching or prolapse) of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope (preloaded with 7 bands). Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS: Forty-one patients were included (median age 52.0, range 27-79 years, 20 men). Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group (P 〈 0.05). Pain after ligation tended to be more frequent in patients treated with the flexible endoscope (first treatment: 3 vs 20 patients, P 〈 0.05). Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION: Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.
文摘AIM:To evaluate the diagnostic efficacies of narrowband imaging(NBI) endoscopy with and without high magnification in distinguishing neoplasia from nonneoplasia colorectal lesions.METHODS:A total of 118 patients with 123 colorectal lesions examined by NBI endoscopy in the Zhejiang Provincial People's Hospital from September 2008 to April 2010 were enrolled in this study.These lesions were classified by pit pattern and capillary pattern,and then assessed by histopathology.RESULTS:Ten lesions not meeting the diagnostic criteria were excuded,the overall diagnostic accuracy of NBI endoscopy in distinguishing neoplasia from non-neoplasia colorectal lesions was 91.2%(103/113),and that of NBI endoscopy with and without high magnification was 93.0%(40/43) and 90.0%(63/70),respectively.Both were significantly higher than that of conventional colonoscopy reported in the literature(P < 0.05),but there was no significant difference between the two groups(P > 0.05).CONCLUSION:Besides NBI magnifying endoscopy,NBI endoscopy without magnification may also be used to distinguish neoplasia from non-neoplasia colorectal lesions.
文摘AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. RESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.